Healthcare Provider Details

I. General information

NPI: 1891464251
Provider Name (Legal Business Name): CHELSEA BICKFORD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2021
Last Update Date: 09/05/2025
Certification Date: 09/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 N RIDGE RD
ELYRIA OH
44035-1241
US

IV. Provider business mailing address

2100 N RIDGE RD
ELYRIA OH
44035-1241
US

V. Phone/Fax

Practice location:
  • Phone: 440-324-1300
  • Fax: 440-277-0409
Mailing address:
  • Phone: 440-324-1300
  • Fax: 440-277-0409

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License NumberFPS.000053
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: